Strange world we live in @freverlost

I'm a cardiologist. A 42-year-old mother of two came to my office complaining of jaw pain and crushing fatigue. She ran half-marathons. Her EKG was normal. Another doctor had sent her home with anxiety medication. When I got her into the cath lab, I found severe microvascular disease — plaque choking the tiniest vessels of her heart, the ones standard angiograms routinely miss. Her heart had been starving in silence while everyone told her she was stressed. She is alive today. Too many women like her are not. Heart disease kills more women than every cancer combined. And medicine is still diagnosing it through a male lens. 84% of cardiologists report having patients in the past year whose heart disease was misdiagnosed by another physician. Women with a STEMI heart attack have a 59% greater chance of being misdiagnosed compared to men. Women with an NSTEMI — 41% greater chance. The reason is structural. For decades, we screened, tested, and treated women using a template built for men. Men's heart attacks announce themselves — the crushing chest pain, the clutched fist, the Hollywood collapse. Women's hearts whisper. Crushing fatigue that feels like wearing a lead vest. Jaw pain written off as TMJ. Nausea blamed on a stomach bug. An ache between the shoulder blades blamed on a long week. Shortness of breath blamed on being out of shape. For years, medicine called these "atypical" symptoms. They are not atypical. They are female-typical. Half of humanity is not a variant. And the biology runs deeper than symptoms. Women have smaller hearts and narrower coronary arteries. Plaque doesn't only clog the big highway vessels — it hides in the microvasculature, the tiny branches feeding the heart muscle itself. A woman can have a heart attack with a completely "clean" standard angiogram. SCAD — spontaneous coronary artery dissection — occurs 90% of the time in women. Often young, fit women with zero traditional risk factors. It's the leading cause of heart attack in women under 50, accounting for roughly one quarter of all cases in that age group. Most doctors have never diagnosed one. And some of the most dangerous cardiac risk factors are hidden in women's medical histories where no one thinks to look: Preeclampsia or gestational hypertension doubles to quadruples lifetime heart disease and stroke risk. Pregnancy is the body's first cardiac stress test — and these complications are early warning sirens, not closed chapters. Autoimmune disease — lupus, rheumatoid arthritis, psoriasis — far more common in women, turbocharges inflammation and plaque formation at any age. Cardiovascular disease in women aged 20-44 is projected to surge nearly 50% by 2050. The youngest patients in my practice keep getting younger. What every woman should ask her doctor — and what every doctor should be asking: "Given my pregnancy history, autoimmune status, and family history — what is my full cardiovascular risk?" If they don't ask about preeclampsia or gestational diabetes, volunteer it. "Should I have an Lp(a) test and a coronary calcium score?" Standard cholesterol panels miss too much. Lp(a) is genetic, one-time, and most women have never been tested. "My tests came back normal but my symptoms haven't stopped — what's next?" Normal stress tests and angiograms can miss microvascular disease, spasm, and SCAD. Persistent symptoms warrant coronary CT angiography or cardiac MRI. And if something feels wrong — say these exact words to your doctor: "I am concerned this could be my heart." That single sentence changes the workup. Do not soften it. Do not apologize for it. 80% of heart disease is preventable. But the playbook has to be built for female biology. Two decades ago, I wrote one of the first books warning that heart disease was the number one killer of women and that medicine was diagnosing it through a male lens. It was recognized by First Lady Laura Bush at the White House during the early years of the national conversation about women's heart health. I'm haunted by how much of that book I could republish today unchanged. The science has advanced. The awareness has grown. But the gap between what we know and what happens in the exam room is still costing women their lives. Share this with every woman you love — and every doctor who treats them. READ MORE: open.substack.com/pub/afshine/p/…

As a neurologist, it is now patently clear to me that the vast majority of people on the planet are suffering from neuroinflammation or brain damage (likely both) The way people speak & behave has changed. Markedly so. Whether irl, or via messaging/social media. It’s noticeable

Brain health is huge reason I take precautions (ie wear n95 everywhere, avoid crowds, don’t eat/drink inside in public). I know 2 people early 60s who developed early dementia after 2-3 covid infections. My mom’s already failing cognition also got worse after her 1st infection.

Cat Herding Science Nerd 🔬 @catladyactivist

2 weeks ago

Data published in npj Dementia shows older Covid survivors experience a 41% increased risk of all-cause dementia and a staggering 77% increased risk of vascular dementia compared to uninfected controls. Leadership and health "care" have abandoned us to this.

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@hannahspierMD 1/Hannah, we have now almost 500,000 peer reviewed published research into long covid now. “Fatigue”, “post exertional malaise (PEM)” “Brain Fog” “difficulty concentrating” are not psychiatric symptoms. They have a pathological basis and clear demonstrable abnormalities 1/

My dad had one known Covid infection. Started forgetting words mid-sentence. Had less control of his emotions, quickly became angry over minor things that previously didn't bother him. Died of sudden cardiac arrest less than a year later. Wear a mask.

Karen Asp 🌱🐾✍️👟 @karenaspwriter

2 weeks ago

Brain health is huge reason I take precautions (ie wear n95 everywhere, avoid crowds, don’t eat/drink inside in public). I know 2 people early 60s who developed early dementia after 2-3 covid infections. My mom’s already failing cognition also got worse after her 1st infection.

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I want to ask you to follow this dot with your eyes. Was that easy? Without you even having to give that much thought, your brain is telling your eye muscles where to move to keep your focus on that dot. 1/

The small blood vessels, not the large ones your cardiologist monitors, are the problem in Long COVID vascular disease. And every standard cardiac test is designed to miss them.

I knew there was no coming back from Covid denial when on the day universal masking disappeared, a physio told me & my team we can “take our masks off now” about 30 seconds after the email was sent. The ward was full of Covid patients. We were the only ones masking on the ward…

Remember the Great Barrington Declaration signers demanding we let our kids catch an unknown virus ASAP so the economy could roar back? 🤔 New OECD study: Long COVID will cost us up to $135B a year, be drag on global economy for the next decade. 👇🏽 bloomberg.com/news/articles/…

Viruses and Joint and Tendon Pain You had a cold two weeks ago. Nothing serious. But now your knee hurts more than it has in months. Your achilles is flaring. Your easy run felt like a half-marathon. You didn't do anything wrong. Here's what's actually happening...

What I’d NEVER do as a brain injury rehab doctor: • Motorcycle • Tackle football (for my kids) • Ignore BP • Skip helmets • Normalize repeat COVID infections Because I take care of what happens next.

3 years after infection, women who had COVID have higher risk of pre-cancerous & invasive HPV-related cancers. Invasive cancer risk increased by 67% for cervical, 131% for vaginal, 98% for vulvar, 92% for anal, & 78% for oropharyngeal cancer. link.springer.com/article/10.100… #LongCovid

Six years ago today, the World Health Organization formally declared SARS-CoV-2 a pandemic virus. Today, though the public health emergency response has ended, the pandemic designation has not changed. You have been lied to. We are still in a global pandemic. 1/

I hate to give airplay to misinformation, but the following post is still online - hasn’t been deleted - and it’s from the person who is currently nominated to be Surgeon General of the United States- who btw doesn’t have an active medical license. This post alone should be disqualifying for the job. Here are the dangerous factual errors in the post: 1) Hep B is not transmitted exclusively through needles and sex; it can also spread perinatally from mother to child, through household contacts sharing items, or other blood exposures. 2) Even if parents test negative, testing isn't perfect - late infections, errors, or incomplete records can and do occur, risking newborns who have a 90% chance of chronic infection if exposed 3) Her claim of zero documented cases from infected playground needles: While rare, there are cases of Hep B transmission from community needlesticks in children. 4) The virus CAN survive on surfaces/needles - up to 7 days or more. 5) Far from "insanity" or "no benefit," the birth dose has reduced U.S. childhood Hep B infections by >95%, preventing cirrhosis and liver cancer. America can’t afford a Surgeon General who so boldly states clear and harmful misinformation, much less someone who doesn’t even feel the need to remove such online falsehoods WHILE AWAITING A CONFIRMATION VOTE. 🤦🏽‍♂️

Casey Means, MD @CaseyMeansMD

2 years ago

The idea of giving a newborn the hepatitis B vaccine (followed by 2 additional doses) if the baby is born to parents *without hepatitis B* is absolute insanity and should make every American pause and question the healthcare system’s mandates. The disease is transmitted through

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@PaulaYScanlan It’s genuinely concerning that you are asking this question. It’s clear that you have no idea of the harms of SARS COV 2. It’s airborne, meaning you breathe it in. Some of us care about our health and the health of others. Some of us actually read the data and understand the data

@DrJesseMorse @M8Void @mryoung151 @bitterbichon If you actually did read the research, you would be wearing an N95 while seeing patients…… so, your behavior says otherwise.

@ShaniceT331135 @mryoung151 @DrJesseMorse Where is this glorious dentist? Would love to have an experience like that!

@JamesThrot Thank you for staying. I for one, appreciate the information you share.

This is spot on! She does a terrific job of summarizing the science in a couple of minutes. Worth a view, even if you’re cc. It’s a great way of connecting the dots.

Julie @hoolie_r

4 months ago

Send this to your left leaning friends who don’t mask

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It's definitely only people hiding in basements and living in fear who are still wearing respirators in 2026. You know... like Olympic athletes and NASA astronauts.